The network of affiliated companies will record and process the data you provide in IT systems. We can assure you that we abide strictly by all the terms of the Data Protection Act when handling any personal data which you provide and which we save in our mutual interests for further business transactions.
Firm name: (Mandatory field)
Street: (Mandatory field)
House number: (Mandatory field)
Postcode: (Mandatory field)
Town/city: (Mandatory field)
Country: (Mandatory field)
Title: Mr Ms
Department:
Forename: (Mandatory field)
Surname: (Mandatory field)
Phone: (Mandatory field)
Fax:
Email address: (email address mandatory)
Purchase order number:
Supplier number:
Delivery date:
Only when it is different to the address stated above! Delivery address:
Pricing terms: EXW (ex works) FCA (free carrier) CPT (carriage paid to) CIP (carriage and insurance paid to) DAT (delivered at terminal) DAP (delivered at place) DDP (delivered duty paid)
Order quantity of BIRKOSIT Dichtungskitt® in 1 kg tins: Please select. 10 kg BIRKOSIT Dichtungskitt 20 kg BIRKOSIT Dichtungskitt 100 kg BIRKOSIT Dichtungskitt 250 kg BIRKOSIT Dichtungskitt Enter another order quantity in kg! Minimum order quantity of 10 kg
Order quantity for LINSEED OIL VARNISH in 1 litre bottles: Please select. 3 litres of LINSEED OIL VARNISH 10 litres of LINSEED OIL VARNISH 30 litres of LINSEED OIL VARNISH 50 litres of LINSEED OIL VARNISH Enter another order quantity in litres! Minimum order quantity of 3 litres
Your value added tax reference no.:
Method of invoice payment: Bank transfer American Express PayPal
Invoice payment: Cash in advance, discount 2 % Net price, 14 days after receipt of the invoice
Our General Terms and Conditions (GT&Cs) apply.
I/We agree to the General Terms and Conditions (GT&Cs).
Right of RescissionInsofar as the customer is considered to be a consumer (Article 13, German Civil Code), the following is valid:
I have printed out and read the Right of Rescission.
Remarks: Please do not fill out this field (spam protection)!
By submitting this form, you consent to the processing of your personal data for the purpose of contacting you. Further information can be found in our data protection declaration.
General Agency in Singapore